Extra-abdominal pneumodissection after laparoscopic antireflux surgery

James A. Harris, Dominic R. Gallo, Darin M. Brummett, Major Daniel J. Mullins, Ramon E. Figueroa-Ortiz

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

The presence of pneumoperitoneum during laparoscopic antireflux surgery can lead to the dissection of carbon dioxide into the mediastinum, retroperitoneum, subcutaneous tissues, and neck (pneumodissection). The purpose of this study is to describe the incidence, extent, duration and pathways of pneumodissection during laparoscopic antireflux surgery. Twenty patients who underwent laparoscopic antireflux surgery from August 1998 through May 1999 were studied. Physical examination and chest radiographs were performed in the recovery room and each day postoperatively. Noncontrast computerized tomography (CT) of the neck, chest, and upper abdomen was also performed on postoperative day one. Subcutaneous emphysema and radiologic evidence of pneumodissection occurred commonly and typically resolved within 4 days postoperatively. The incidence of pneumomediastinum (85%) seen on CT scan was similar to that of pneumodissection into the neck (80%). The most common pathway of dissection of gas was through the anterior mediastinum and into the neck through the carotid space. Other findings on CT scan revealed pneumoperitoneum in 70 per cent, pneumoretroperitoneum in 10 per cent, and pneumothorax in 0 per cent. The dissection of gas into the mediastinum, neck, and subcutaneous tissues is very common after laparoscopic antireflux surgery. Subcutaneous emphysema on physical examination and radiographic pneumodissection typically resolves within 3 to 4 days. After this time one should consider the presence of any substantial amount of gas as a potential complication related to the procedure.

Original languageEnglish (US)
Pages (from-to)885-889
Number of pages5
JournalAmerican Surgeon
Volume67
Issue number9
StatePublished - Dec 1 2001

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Laparoscopy
Neck
Mediastinum
Subcutaneous Emphysema
Dissection
Pneumoperitoneum
Gases
Subcutaneous Tissue
Tomography
Physical Examination
Retropneumoperitoneum
Thorax
Recovery Room
Mediastinal Emphysema
Incidence
Pneumothorax
Carbon Dioxide
Abdomen

ASJC Scopus subject areas

  • Surgery

Cite this

Harris, J. A., Gallo, D. R., Brummett, D. M., Mullins, M. D. J., & Figueroa-Ortiz, R. E. (2001). Extra-abdominal pneumodissection after laparoscopic antireflux surgery. American Surgeon, 67(9), 885-889.

Extra-abdominal pneumodissection after laparoscopic antireflux surgery. / Harris, James A.; Gallo, Dominic R.; Brummett, Darin M.; Mullins, Major Daniel J.; Figueroa-Ortiz, Ramon E.

In: American Surgeon, Vol. 67, No. 9, 01.12.2001, p. 885-889.

Research output: Contribution to journalArticle

Harris, JA, Gallo, DR, Brummett, DM, Mullins, MDJ & Figueroa-Ortiz, RE 2001, 'Extra-abdominal pneumodissection after laparoscopic antireflux surgery', American Surgeon, vol. 67, no. 9, pp. 885-889.
Harris JA, Gallo DR, Brummett DM, Mullins MDJ, Figueroa-Ortiz RE. Extra-abdominal pneumodissection after laparoscopic antireflux surgery. American Surgeon. 2001 Dec 1;67(9):885-889.
Harris, James A. ; Gallo, Dominic R. ; Brummett, Darin M. ; Mullins, Major Daniel J. ; Figueroa-Ortiz, Ramon E. / Extra-abdominal pneumodissection after laparoscopic antireflux surgery. In: American Surgeon. 2001 ; Vol. 67, No. 9. pp. 885-889.
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